CASEY DISTASO

WEST HOLLYWOOD, CA
NPI1003311747
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: CA  A196321)
Additional Taxonomies207P00000X Emergency Medicine
(Licence: TN  62985)
207P00000X Emergency Medicine
(Licence: IL  125.072192)
2083C0008X Preventive Medicine, Clinical Informatics Specialist
(Licence: CA  A196321)
Enumeration Date2018-03-26
Last Update Date2024-06-07
Business Address
CASEY DISTASO MD
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048-1804
Phone number: 310-423-8780
Mailing Address
CASEY DISTASO MD
4140 W 190TH ST
TORRANCE, CA 90504-5513
Phone number: